Urban hospitals in disarray
We have discussed in prior entries the fact that the lack of health insurance affects all of us as, hospital emergency rooms are overwhelmed by primary care patients. Prior studies by the medical profession confirm that as a greater percentage of Americans becomes uninsured, the waiting time in emergency rooms increases and the potential for time delay-related negative treatment outcomes is increased. A recent study of conditions in the Los Angeles area helped to highlight and confirm some of these problems.
L.A. has become something of a harbinger of the future for the rest of us, since the primary hospital serving South LA, King-Harbor Medical Facility, was closed. Elderly and poor patients now line up at neighboring hospitals at 6:30 in the morning, waiting for clinics to open. Many will wait half the day to be seen. Some have to travel 8 to 14 miles for routine care: in LA's over-crowded infrastructure, that can mean a drive of 45 minutes or more. Roughly 14 percent of the nation's uninsured live in California, and California pays 12 percent less reimbursement for Medicaid patients than the next-lowest state. The governor has proposed an additional ten percent cut in this rate, which would take 240 million more dollars out of LA medical care.
With poor economic conditions, cuts in government reimbursement and a higher threshold for Medicaid eligibility, and employers dropping health coverage due to spiraling costs, more and more people are relying upon government services through hospitals in order to treat routine illnesses--or neglecting problems until they are acute and life-threatening. In LA, the number of patients relying on Medicaid health insurance increased 18 percent in the past 5 years, and the number of uninsured rose by 20 percent. This problem is compounded by the removal of 2.2 million people from Medicaid rosters in 2005, and the bankruptcy or closure of facilities in the greater LA area serving 100,000 patients per year. While the average in the country is 4.3 hospital beds per 1,000 residents, in Southern California, there is not even one bed per thousand residents.
The effect? Inadequate health care for many, unreasonable delays for all, and increased pressure on the health care infrastructure and the government. Something must be done with our health care system, but perhaps it won't occur until the decay that is already apparent in our cities and rural areas overwhelms the suburban systems that serve the declining middle class.